Healthcare Provider Details

I. General information

NPI: 1891471843
Provider Name (Legal Business Name): BEST LIFE PHYSICAL THERAPY PT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7728 JACOBO DR NE
ALBUQUERQUE NM
87109-6407
US

IV. Provider business mailing address

7728 JACOBO DR NE
ALBUQUERQUE NM
87109-6407
US

V. Phone/Fax

Practice location:
  • Phone: 801-455-3890
  • Fax:
Mailing address:
  • Phone: 801-455-3890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA DAVID DEIFEL
Title or Position: PRESIDENT
Credential: PT, DPT
Phone: 801-455-3890